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Home My WebLink About335 REIMS LN - Building Permits 1 _ CITY OF COSTA MES • A n� BUILDING DIVISION t ' DEVELOPMENT SERVICES DEPARTMENT / P98-00552 PERMIT V PERMIT NUMBER (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 335 REIMS LN .,,- .. -- ---- -- Status: ISSUED Suite No Applied: 07/07/1998 Issued: 07/07/1998 Vicinity: Parcel Nunmber: 43914149 _ - - - - -- , • Applicant NOCK, RON I Address: __ __ _ .Phone=^=�f-%.=..+-:._,.z--'-`-� Zi __,z/t<CLXH,..-- C--\ \-3 c:p� 11/01S:.'-s --.;;, L 1 Owner. RUMBLE-VIVIAN /ENri Address 335 REIMS LN ' �.,'1 ,UY�// A�/\-P one: -�.A �� ,-;:„ .\ � J(/COSTA MESA,CA / Zip: 92627 Contracto»�J/��CARSON,ROOFING AND INSPECTION Address: '1207 N.CITfiliRON LN /i9' � j � � , Phone: f14-635-4912 t ��} v ANA Zip:`92801 \� .,,...---..) ,N gpiiii-r-- ) :4,v.,. .., J ,,,,_License:X661526 i i \h/Eng: ARSON ROOFING7AND INSPECTION ° Address: ,1120c7�;,N�CITRON.LN ��;"�1�1 t t ,�� Yr�'�) �,,y Phone: 714-635-4912 \N, i , I .tt , I: jANA ��' - Zip:=92801=--- I.'`I I' �'/y��I� � 'lPP tiicenseM661526 �0 �0 (��0 �'. : �I1�',�)1 ��u��.. G' "� l�lt'd OOd.f-2AJ��('JU:v� I 1'.,I L , ) ic. In '(((`�\\\ i I !SCOPE OF PERMIT )/ Y. i f ,� ,�1� �'t\IDISHWASHER \ rye� 'Y : ) 1 r'-J 'Ai'( 1»JJJ �� 111 �I �� \ _ %nl Intl ISIAI '� FEE�SUMMARY/ / uf4V/' L� � \ MT OTYJ �� AMT-�OTY�� AM1 r ISSUE FEE \\ $22.00 Laundry Tub/Washer `-$0.000 Sump Pump4 $0.00 0 Backflow,irrigatiim .\ \$0:00 0 Landscape Irrigation $0.00 0 Swimming,Pool `: $0100 0 Backflow Pre'ventar/� $0'.00, 0 P-Trap 41,,,.E $0.00 0 Trap Primer $0'.00 0 Bathtub \\�\ \_- $0:001 0 Pressure Regulator.(1,?' ,$0.00 0 Urinal/a/ $6(00 0 Clarifier System $0.00\ �0 Process Piping(per 10ift)Gp$9A0 0 Vacuum.Brkr Bkflow(1-4)/$6.00 0 Connect(Ice,Sooda,etc) I^$0.00 0 Receptors 0;04424-100i$0160?,--� 0 Vacuum Brkr Bkflow(5+) ,$0.00 0 Dental Units \\''''§, �= $0.000 „,-;i-.Septic Tarikj 1/4 V $0:00 JOA• �WasKBasin f$0.00 0 Dishwasher $8:75i 1\ • yN c§eSewer Cap for_De mo- �Cy $0:00 13C.,0, -,Wash�C Basin.Set & $0.00 0 \..- ) tip. i._„ --4 4L .r)6 Drain, Floor �‘ $0.00 0Sewer�Connect 1". n `'(i $0.00 0Waste'and Ven[System $0.00 0 Drain, Rainwater a $0:00 / 0Sew`e,Private Line'�S)6' x$0.00 :0 Waterr'Closet(Toilet)/ $0.00 0 Drain, Roof $0;00✓ (0 'Jr-, Shower` - ' �(Sl - �-.y $0 00 0%^ \ ,,A;-, -.... terfvent $0.00 0 Drinking Fountain ' $0.00 'N0 v/r--Sink, bar- ---=1-_$0:00-0 Water Piping/(Inst or Rep.) $0.00 0 Expansion Tank $0.00-\ 0 CSInk,commercial $0.00 0- \ - P � 1 -� � ;�Water.Re-pipe $0.00 0 Gas Earthquake Valve $0.00:,`<-'0.\ /. Sink FFloor,-- F--_,--1(2.-1 `$0:00 Gy-,y0�1r 1 Water-Service $0.00 0 Gas(1-4 outlets) $0.00 ��0"7.:...,:z--_. - Sink,kitchen I i i; ..] ,$0'00 '-o\-- i:Water Softener $0.00 0 Gas(Over 4 outlets) $0.00 6- >�Sink,service/mopl�.\Ur iso o1"- 0,...-,- / OTHER $0.00 Gas Repipe $0.00 0 \"-=Spa(private) .K. ,. ,,,,$0.00_ ";07.-,-;---- VIOLATION $0.00 Gas Service $0.00 0 Spa-(public)=-----?-- -d,---.4._-:.:.$0.061:-.1110. '--- PLAN CHECK $0.00 Interceptors(Grease,Oil) $0.00 0 --- REINSPECTION $0.00 0 Interceptors(Sand Auto) $0.00 0 TOTAL CALCULATED FEES: $30.75 COMMENTS/SPECIAL CONDITIONS • re ViED - an 1 EXPIRATION: This permit shall automatically expire and become void If work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5628 DECLARATIONS . f n WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: • • ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. p/lhave and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is issued. My workers' pensa Io,.n/Insurance r and policy number are: U-7 Carder: L�-PM . .Policy Number '7'7 93 �TQa (This section need not be completed I/the permit is va ed at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Calif."-,a a, ee that If I shout ecome subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shell forthwith comply with these prov -/ 'pllcant Signature: Date: / WARNING:FAILURE TO SEC �ORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SWILL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THrx$RAND DOLLARE($108000),IN ADDRION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST.AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Cjtapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is in full force and effect.Lic.# Class# C'�kontractors Signature: �� ^ - Date: —hiY 77'"'CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,CMI Code). Lenders Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its Issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such Improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or Improve for purpose of sale.). ❑ I,as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec. 7044, Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-properly tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth Into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,faLsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2.Art 2,Sec. 341,Titre B,California Administrative Code). ❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No - (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP Is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No B (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given Is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property,for.inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. -re Of Legal O4iner(s Dante CrA And/Or Authorized Awn 7 Date pp CODE 4. INSPECTIONTYPE DATE lCAlS gal INSPECTION TYPE DATE . !MAU 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final - 208 Final Plumbing 200 • Anal Re-Roof - 210 Final Electrical ' 201 Final Block/Retaining Wall 212 Anal Fire Prevention • • 202 Final Factory,Flre Place , • 220 Anal Planning Approval 203 Final Sign 222 Final Site • 204 Final Demolition - 250 Final Building/Occupancy 2446-45 • rtt IftCLIVED • • 9637 dim s I963 COSTA MESA BUILDING-SAFETY DEPARTMENT rFINANCE DEPT. P.O.BOX 317 COSTA MESA.CALIFORNIA CITY OF COSTA MESA For Applicant, to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING For Office Use Only BUILDING �2) 5 �n ,,^ n ^ ADDRESS' Y `'II �'�-� RECEIPT NO. PARA,T NO. . COSTA MESA, CALIFORNIA 1n37 \j ,,I jJJ/r ��y�// /• RIVE-BY DATE RECEII ED DATE ISSUED OWNER D0k.1 y {1'✓�///Nl({1JI '`jA✓(/((-1 ,� 9_I�� IIIA) ? 1963 MAIL .f III S/ /liar)ci (P✓- is- 1 C..• _ DRESS t �� /J7 A•ORE58 u1 ADDRESS p G n C-1' ✓ / FIRE `/�, I ret TFLRQ yoao ZONE TYPE GROUPS-�C' CITY8"�C 1•!1'1 l 1-!O�_BL q � y APPROVED AOP IN ER Aia/' Ca 4/1' h NO.r/4 J-'AiO BY DATE /00O / Cen0/ ZONING / ADDRESS U 117W FA-/ p/A, ))) Lf ZO _1..I' NO. S �J I USE OFDI NE,� PLANS(/,T` BUILDINB �/ - CONTRACTOR �¢'L✓"�-�'• Loy_ L/9 /„cap 3 y33 k . LEGAL //�---��000! �T 7 ADDRESS. DESCRIPTION CITY - S. 'ter A.P.NO.I - -- NOTE: NO SAVE OVERHANG SHALL BE LESS THAN STATE // /� TEL,,J� SO"TO Slag V REAR P.L. LIC.NO./J/��-U�^V"/ NO. /�� • U,--O EAVES SIFLZEOT 3.3? �/ s3-, / NO.OF BLOCS. NOW ON LOT ALLOWED (U.B.C.REQUIREMENT) O k '� YARDS APPROVED YARDS APPROVED USE OF MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. (FROM C/LSTREET) SETBACK LINE FROM ''] 1 S 0 FRONT 0 FT. FT. CENTER OF STREET - t� REAR YARD SIDE YARD LEFT / I RIGHT R.SIDE O FT. FT. - DESCRIPTION OF WORK I,.SIDE 0 FT. N. X ALTERATION _ ADDITION REAR 0 FT. FT. DISTANCE BET. BET.MAIN& REPAIR MOVINGDEMOLISH MAIN SLOGS. ACCESS.BLOCS. BUILDING• NO.OP '7 VAR'# DATE SIZE ',j 3XSJ•SS ROOMS / STORIES 2 - - C.U.P.# n APPROVED EXTERIOR WALL11,,ff''''// ROOF �A APPROVED COVERING J7[/«.-OI COVERING C 1t'VP OY DATE 5.--‘7194� USE OF BUILDING AND WORK /nTO�yBE PERFORMEDRV ea;UeaC L w.✓/�'7 // a e Ce CRk&Q P DIU 7. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHO UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM• PURPOSE OF EST LISHING A PERMIT FEE ONLY. F' O PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION - BUILDING CONSTRUCTION. / /II ei N SIGNATURE OF ,r ?luta,. (n- I &. of PERMIT FEE § 3 PERM ITTEF ;`^ u-LJ We • 'Z4'C, JL� .�/ / $7 r I{^,J $/9 ,5j 7� PLAN CHECK $ 3/ N 0 AUTHORIZED AGENT V\ I �"� f YWlll I/ SQ S. • TOTAL FEE If OWNER , DOYLE & SHIELDS Development Co. , INc. DATE 6-3-63 JOB ADDRESS 335 Reims BUILDING PERMIT NO. 19637 GENERAL CONTRACTOR Doyle & Shields Dev.Co. ,Inc. VALUE $ 19,540.00 AP No. LOT 49 TRACT 3433 FIRE ZONE DESCRIPTION OF WORK Res.watt.gar. INSPECTIONS Signature DATE GROUP I&J TYPE V ZONE R-2 Soil 4-its 7/-63 PERMITS ISSUED GasSUBCONTRACTOR DATE NUMBER �� Water ,/d 3a 63 Rough Com. Refrig. 0 Air Cond. 0 . Rough Heating ,S .// --e., -. ___ JUL 2 2 1953 1 C3 7O Rough Plumbing fS /v-3O-63 A. . . /as. . . -,2.y-/J 3,C&i _ V Miscellaneous / Prop. Swr. Line ;TA H•use Co ®'St. Swr. 0 tt 2- =G' a - 1F p'0 - a• Sprinkling System IF, , ill i'r , • -i7- - ' - "�{�s,; .9--/7-.4sz&- �`�4(,�' Construction Pole / 1 Underground La ,p WWI, WWW" . ! n ,I Rou n wiring _' 1�. /-r Fp I �-5-63 G07,6 Trenches ' Forms)- Steel Reinf.,Fa-- Ar 7-2,-- 7 VI Floor System F 7� 7 Bond Beam 0 Steel Reinforce 0 u [j ' Sheathing r_ /2:%" 3 Frame and Flashing Ly��/� /3 ,\I / ', / Lathing - In,4- OutZ'� -� /l_/J...� �? ,A1 Plaster, brown coat •+- /1 - yv f / n-. �l �" Refrig. 0 Air Con. 0 Final �J "{ Heating, Final /I .S 27-{,4' it 0 / ` Plumbing Fixtures, Final Yak -- 6 ✓ I. / V ' Final Gas Test/v-- kra._3 5/- q yr U Electric Fixtures, Final a, 4-‘4,-. Building, Final , .5 3-37-04 I I OCCUPANCY / Form BU4-5M-3-63--S-B P HOLD FOR SPELL/AL KMyy.rh•M::NTC